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Neurosurgeon shortage

Expect more of this to happen:

As a group, specialists are getting older and less willing to work on call. Many specialists say they fear they are more likely to get sued by emergency patients than by their regular patients, who know and trust them. Even when hospitals pay doctors for working on call, specialists often make less money working emergencies than they do caring for regular patients.

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EMTALA and "social admits"

Scalpel: “‘Social’ admits to the ‘no-doc’ admitting staff are usually about as welcome as a fart in an elevator. Particularly when they are unfunded midnight weekend language-barrier system-abusing complicated social admits of questionable medical necessity.

When patients like you get admitted, you tend to be challenging for the hospitalists to discharge too, so you end up receiving much more medical care than the emergency stabilization which is mandated …

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Man sues hospital for a "forced" rectal exam

In cases involving trauma, a rectal exam is one way to assess for neurological damage. In our malpractice-mad society, this resulted in a frivolous lawsuit:

A construction worker claimed in a lawsuit that when he went to a hospital after being hit on the forehead by a falling wooden beam, emergency room staffers forcibly gave him a rectal examination . . .

. . . says in court …

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Why the unnecessary CT scans?

For starters, not ordering a CT scan is more likely to have negative repercussions for the physician:

The cancer caused by a CT scan doesn’t generally show up for decades “” and there are all sorts of other intervening reasons why a patient would develop cancer “” so no one is too scared of getting sued for ordering a CT scan. Getting sued for not ordering one is …

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Opting out of Medicare

DrRich looks at how feasible that would be.

The fact that many physicians are piss-poor at business and have learned to bend over and keep taking it during medical school and residency places doctors at a disadvantage during any difficult negotiation. We need to toughen up as a profession.

"Stroke Code"

A man has a massive stroke. Read about how things should be done in the ensuing events at the Stanford ER.

Autism or disease mongering?

Maggie Mahar on the AAP’s recommendation to be more vigilant in autism screening:

“The pediatricians are, as far as I’m concerned, going about this a bit impulsively””as very, very few have a clue about what would be appropriate treatment for a child who truly screened positive at, say, 14 months. And the risk of really stressing the child further by exposing him to treatments appropriate for a 2-1/2 to 3-year …

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The dangers of overscreening

Those who think “more testing is better medicine” needs to become better versed in the dangers of false positives:

Many of the scans yield false-positive results, which lead to unnecessary (and risky) treatments. Even recommended tests yield a scary number of false readings. Take mammograms, an often promoted routine exam. According to research compiled by the U.S. Agency for Healthcare Research and Quality:

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Gift card for medical services

With the holidays approaching, why not give the gift of health?

But Highmark Inc., the Pittsburgh-based health insurer, hopes its new Healthcare Gift Card will encourage people who might be reluctant to visit the doctor or spend their money on prescriptions — namely, seniors and college students — to do so.

The card itself costs $4.95, and can be loaded with as little as $25, which might cover a …

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Brain surgery for schizophrenia

Nearly unheard of in the Western world, but not in China, where’s fee-for-service gone wild:

Mi Zhantao, a poor 25-year-old living with his parents outside this provincial capital in eastern China, was battling depression and had trouble socializing. Doctors said he had schizophrenia. They recommended brain surgery.

Mr. Mi’s family spent about $4,800 — the equivalent of four years’ income, and more than their life savings — on …

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Calling out the quacks

Ads for quackery are starting to use some scientific-sounding terms. To help tame the spread of this misinformation, all it takes is a simple phone call. (via Schwitzer)

"The board game of recreational surgery"

How twisted and bizarre:

Pain Doctors – The Game of Recreational Surgery is a Machiavellian board game, played within the gothic horror environment of a 19th century style hospital known only as “The Facility”.

The object of the game is to become Chief Surgeon by taking as many patients as you can into surgery, with the intent of extracting as much pain as possible without actually killing them.

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What it’s like to die

A somewhat disturbing article. Here’s what they say about decapitation:

Beheading, if somewhat gruesome, can be one of the quickest and least painful ways to die – so long as the executioner is skilled, his blade sharp, and the condemned sits still.

(via Maria)

Brain surgery in a day

The UK’s youngest brain surgeon (at age 35) pioneers the same-day, no general anesthesia, brain tumor surgery.

Is speed really something that should be emphasized for brain surgery? If it were me, I’d want the neurosurgeon to take their time. (via Healthbolt)

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